DR. DOROTHY T PRUSEK M.D.
NPI 1871592378
Internal Medicine in Elmhurst, IL

Q: What is Dorothy Prusek's NPI number?

The NPI number for Dorothy Prusek is 1871592378. It was assigned to this individual provider in the NPPES registry on July 18, 2005.

Q: What is Dorothy Prusek's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Dorothy Prusek was last updated on February 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 18, 2005PECOS EnrolledAccepts Medicare Assignment

91.35/100

CMS Quality Rating

755 N YORK ST, ELMHURST, IL 60126(331) 221-2900(331) 221-2733 Get Directions Write a Review

NPPES record last updated: February 8, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 8, 2021, Feb 1, 2021, Mar 17, 2016 and 1 more (4 updates tracked since 2016).

On this page

About Dr. Dorothy T Prusek M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DOROTHY T PRUSEK M.D. (NPI 1871592378) is an individual internal medicine provider in Elmhurst, Illinois, licensed in Illinois (036081546) and active in the NPI registry since July 2005. She is enrolled in Medicare PECOS, is affiliated with Elmhurst Memorial Hospital, and is a graduate of Other (1987).

NPPES Registry Identity

NPI1871592378

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameDR. DOROTHY T PRUSEKCredential: M.D.

Location Address755 N YORK STElmhurst, IL 60126-1607

Mailing Address755 N York StElmhurst, IL 60126-1607 · (331) 221-2900 · Fax (331) 221-2733

Phone(331) 221-2900

Fax(331) 221-2733

Sole ProprietorNo

Medical School CMSOtherGraduated 1987

Enumeration DateJuly 18, 2005

Last NPPES UpdateFebruary 8, 20214 updates tracked since enumeration

NPPES CertifiedFebruary 8, 2021

✔ NPI 1871592378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 036081546

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

755 N YORK ST, Elmhurst, IL 60126

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Other Identifiers 2

Other02232472IL · Blue Cross/blue Shield #

Medicaid036081546IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Dorothy T Prusek M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID345221115

PECOS Enrollment IDI20040527000247

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

290 services159 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

245 services245 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

56 services50 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

25 services24 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

25 services24 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

24 services20 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Elmhurst Memorial Hospital

Acute Care Hospitals · Elmhurst, IL

4/5 CMS rating

OwnershipProprietary

CMS Certification Number140200

Location155 East Brush Hill RoadElmhurst, IL 60126 · Du Page County

Emergency services Birthing friendly

Edward Hospital

Acute Care Hospitals · Naperville, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140231

Location801 South WashingtonNaperville, IL 60540 · Du Page County

Emergency services Birthing friendly

Alexian Brothers Medical Center 1

Acute Care Hospitals · Elk Grove Village, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140258

Location800 Biesterfield RdElk Grove Village, IL 60007 · Cook County

Emergency services Birthing friendly

Loyola University Medical Center

Acute Care Hospitals · Maywood, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140276

Location2160 S 1st AvenueMaywood, IL 60153 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60126 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$137.43 typical visit price

range $59.81 – $181.38

Typical copayment $34.35 (range $14.95 – $45.34)

Most-billed visit code 99204

Established Patient

$105.07 typical visit price

range $19.15 – $147.12

Typical copayment $26.26 (range $4.78 – $36.78)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.35/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

82.71

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

20 suppliers64 claims156 services$5.25 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

8 suppliers15 claims15 services$0.95 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

5 suppliers16 claims16 services$33.81 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

5 suppliers12 claims12 services$44.14 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

4 suppliers13 claims13 services$14.53 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

5 suppliers20 claims120 services$1.76 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FRANKLIN CHANG

Family Medicine